Okanoue Takeshi, Makiyama Akiko, Nakayama Mika, Sumida Yoshio, Mitsuyoshi Hironori, Nakajima Tomoki, Yasui Kohichiroh, Minami Masahito, Itoh Yoshito
Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto 602-8566, Japan.
J Hepatol. 2005 Oct;43(4):599-605. doi: 10.1016/j.jhep.2005.04.008.
BACKGROUND/AIMS: Long-term follow-up study was performed to identify the candidates for antiviral therapy for hepatitis C virus (HCV) infection among carriers with persistently normal aminotransferase (ALT< or = 30 U/L) levels (PNAL).
One hundred and twenty-nine HCV carriers with PNAL who underwent liver biopsy and had platelet count over 150,000/microl were entered and 69 were followed for over 5 years. Thirty-five patients underwent serial liver biopsies. Serum ferritin and thioredoxin levels were also determined.
Seventeen patients had normal liver histology, 10 had moderate chronic hepatitis and the remainder 102 had mild hepatitis. Serum ferritin and thioredoxin levels were normal. The mean follow-up period for the 69 patients was 8.5 years. Of these 69 patients, 10 had persistently normal ALT levels (group A), 39 had transient elevation of ALT (group B), and 20 changed to symptomatic chronic hepatitis (group C). The rate of progression of fibrosis for groups A, B, and C were 0.05, 0.04, and 0.08, respectively. Hepatocellular carcinoma was not diagnosed in any of the patients.
Around 90% of HCV carriers with PNAL have normal to mild liver histology. This long-term follow-up study demonstrated that 30% of such carriers became candidates for antiviral therapy within 5 years.
背景/目的：进行长期随访研究，以确定丙型肝炎病毒（HCV）感染且转氨酶水平持续正常（ALT≤30 U/L）的携带者（PNAL）中适合抗病毒治疗的患者。
纳入129例接受肝活检且血小板计数超过150,000/微升的PNAL HCV携带者，其中69例随访超过5年。35例患者接受了系列肝活检。还测定了血清铁蛋白和硫氧还蛋白水平。
17例患者肝组织学正常，10例为中度慢性肝炎，其余102例为轻度肝炎。血清铁蛋白和硫氧还蛋白水平正常。69例患者的平均随访期为8.5年。在这69例患者中，10例ALT水平持续正常（A组），39例ALT短暂升高（B组），20例转变为有症状的慢性肝炎（C组）。A、B、C三组的纤维化进展率分别为0.05、0.04和0.08。所有患者均未诊断出肝细胞癌。
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